Front-Line innovation: Rapid implementation of a nurse-driven protocol for care of outpatients with COVID-19.
J Clin Nurs
; 30(11-12): 1564-1572, 2021 Jun.
Article
in English
| MEDLINE | ID: covidwho-1069408
ABSTRACT
AIMS AND OBJECTIVES:
Our objective was to rapidly adapt and scale a registered nurse-driven Coordinated Transitional Care (C-TraC) programme to provide intensive home monitoring and optimise care for outpatient Veterans with COVID-19 in a large urban Unites States healthcare system.BACKGROUND:
Our diffuse primary care network had no existing model of care by which to provide coordinated result tracking and monitoring of outpatients with COVID-19.DESIGN:
Quality improvement implementation project.METHODS:
We used the Replicating Effective Programs model to guide implementation, iterative Plan-Do-Study-Act cycles and SQUIRE reporting guidelines. Two transitional care registered nurses, and a geriatrician medical director developed a protocol that included detailed initial assessment, overnight delivery of monitoring equipment and phone-based follow-up tailored to risk level and symptom severity. We tripled programme capacity in time for the surge of cases by training Primary Care registered nurses.RESULTS:
Between 23 March and 15 May 2020, 120 Veterans with COVID-19 were enrolled for outpatient monitoring; over one-third were aged 65 years or older, and 70% had medical conditions associated with poor COVID-19 outcomes. All Veterans received an initial call within a few hours of the laboratory reporting positive results. The mean length of follow-up was 8.1 days, with an average of 4.2 nurse and 1.3 physician or advanced practice clinician contacts per patient. The majority (85%) were managed entirely in the outpatient setting. After the surge, the model was disseminated to individual primary care teams through educational sessions.CONCLUSION:
A model based on experienced registered nurses can provide comprehensive, effective and sustainable outpatient monitoring to high-risk populations with COVID-19.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Transitional Care
/
COVID-19
Type of study:
Cohort study
/
Prognostic study
/
Qualitative research
Limits:
Humans
Language:
English
Journal:
J Clin Nurs
Journal subject:
Nursing
Year:
2021
Document Type:
Article
Affiliation country:
Jocn.15704
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